Measurement Of Depression In Patients Research Articles

Psychometrics and diagnostics of the Italian version of the Beck Depression Inventory-II (BDI-II) in Parkinson’s disease

IntroductionDepression is one of the most disabling neuropsychiatric manifestations of Parkinson’s disease (PD) and requires proper screening and diagnosis because it affects the overall prognosis and quality of life of patients. This study aimed to assess the psychometric and diagnostic properties of the Beck Depression Inventory-II (BDI-II) in an Italian PD cohort.Materials and methodsFifty consecutive outpatients with PD underwent the Italian version of the BDI-II and other questionnaires to evaluate anxiety and apathetic symptoms. Patients’ caregivers completed the depression/dysphoria domain of the Neuropsychiatric Inventory (NPI-D). We evaluated the internal consistency, convergent and divergent validity, and factorial structure of BDI-II. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios were computed using ROC analyses, and an optimal cutoff was defined using the Youden index.ResultsThe BDI-II proved to be internally consistent (Cronbach’s α = 0.840) and substantially met the bi-factorial structure. Regarding construct validity, the BDI-II was substantially related to anxiety measures, but not to apathy. With the combination of the NPI-D and anxiety score used as the gold standard, the BDI-II overall showed good accuracy (AUC = 0.859) with adequate sensitivity (75%) and specificity (87%). The optimal cutoff point was defined at 14.50.ConclusionsWe provide evidence of the psychometric and diagnostic properties of the Italian version of the BDI-II as a screening tool for depression in patients with PD. The BDI-II was found to be reliable and valid for the measurement of depression in patients with PD; therefore, it is available for use in clinical research and practice.

Rasch analysis of the Beck Depression Inventory-II in stroke survivors: A cross-sectional study

BackgroundThe Beck Depression Inventory-II (BDI-II) is often used to assess depressive symptoms among stroke patients, but more evidence is needed regarding its psychometric properties in this population. The purpose of this study was to assess the BDI-II׳s psychometric properties using a Rasch model application in a sample of patients 6 months after a first clinical stroke. MethodsData were collected prospectively from patient medical records and from questionnaires (with assistance if needed) as a part of a longitudinal study of poststroke fatigue. Data from the 6-month follow-up were used in this analysis. The sample consisted of 106 patients with first-ever stroke recruited from two Norwegian hospitals between 2007 and 2008. Depressive symptoms were measured with the BDI-II. Rasch analysis was used to assess the BDI-II׳s psychometric properties in this sample. ResultsFive BDI-II items did not demonstrate acceptable goodness-of-fit to the Rasch model: items 10 (crying), 16 (changes in sleep), 17 (irritability), 18 (changes in appetite), and 21 (loss of interest in sex). If these 5 items were removed, the resulting 16-item version not only had fewer items, it also had better internal scale validity, person-response validity, and person-separation reliability than the original 21-item version in this sample of stroke survivors. LimitationsThe study did not include a clinical evaluation of depression. ConclusionA 16-item version of the BDI-II, omitting items 10, 16, 17, 18 and 21, may be more appropriate than the original 21-item BDI-II for use as a unidimensional measure of depression in patients following first-ever stroke.

Psychometric Properties of the Patient Health Questionnaire-9 in Patients With Heart Failure and Gastrointestinal Symptoms.

Patients who have coexisting medical conditions tend to be more depressed. The purpose of this study was to examine the reliability, validity, and dimensionality of the Patient Health Questionnaire-9 (PHQ-9) in patients with heart failure and gastrointestinal (GI) symptoms. The cross-sectional data for this secondary analysis were collected in four studies. Cronbach's alpha was used to examine reliability. Concurrent validity with the Beck Depression Inventory-II (BDI-II) was examined. Cronbach's alpha for the PHQ-9 was .87. Concurrent validity with BDI-II was excellent (r = .78, p < .01). The evidence from this study supports the reliability and validity of the PHQ-9 as a measure of depression in patients with heart failure and GI symptoms.

Psychometric Properties of the Patient Health Questionnaire-9 in Patients With Heart Failure and Gastrointestinal Symptoms

Background and Purpose: Patients who have coexisting medical conditions tend to be more depressed. The purpose of this study was to examine the reliability, validity, and dimensionality of the Patient Health Questionnaire-9 (PHQ-9) in patients with heart failure and gastrointestinal (GI) symptoms. Methods: The cross-sectional data for this secondary analysis were collected in four studies. Cronbach's alpha was used to examine reliability. Concurrent validity with the Beck Depression Inventory-II (BDI-II) was examined. Results: Cronbach's alpha for the PHQ-9 was .87. Concurrent validity with BDI-II was excellent (r = .78, p &lt; .01). Conclusions: The evidence from this study supports the reliability and validity of the PHQ-9 as a measure of depression in patients with heart failure and GI symptoms.

1244 – Bipolar depression rating scale (BDRS): psychometric characteristics of the italian validation

The scales for the assessment of depressive symptoms, translated and validated in Italian, lacks in the recognition of the psychopathological nuances of the disorder. The Bipolar Depression Rating Scale (BDRS) is a tool specifically built to reflect the characteristics of bipolar depression. Screening criteria: - aged 18–65 years - diagnosis of BD (DSM-IV-TR) (125 patients) or - diagnosis of MDD (DSM-IV-TR) (30 patients) - manifestation of depressive symptoms - no further psychiatric comorbidity on axis I and axis II (including abuse/addiction) - no serious cognitive deficits Psychometric battery: Bipolar Depression Rating Scale (BDRS), Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS). The analysis of the BDRS scores, according to the Kolmogorov-Smimov method shows a normal distribution; the α Cronbach's coefficient shows that the the scale, in its Italian version, has considerable validity and reliability (r = 0.82). The factor analysis was verified using the Varimax rotational method: after several tests, we found 2 subscales, one linked to mixed/depressive symptoms and a second related to (hypo)manic symptoms. The BDRS is a valid scale for the measurement of depression in patients with Bipolar Disorder, with a notable internal consistency (Cronbach α 0.82), a significant consistency between items/total (Cronbach α from 0.80 to 0.82) and positive correlation with other scales (MADRS r 0.67, p < 0.001; HAM-D r 0.81, p < 0.001; YMRS r 0.46 p < 0.0001), including the Young Mania Rating Scale (better than the original validation sample Berk et al., 2007).

Evaluating Depressive Symptoms in Schizophrenia: A Psychometric Comparison of the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale

Background: The aim of this study was to compare two measures of depression in patients with schizophrenia and schizophrenia spectrum disorder, including patients with delusional and schizoaffective disorder, to conclude implications for their application. Sampling and Methods: A total of 278 patients were assessed using the Calgary Depression Scale for Schizophrenia (CDSS) and the Hamilton Depression Rating Scale (HAMD-17). The Positive and Negative Syndrome Scale (PANSS) was also applied. At admission and discharge, a principal component analysis was performed with each depression scale. The two depression rating scales were furthermore compared using correlation and regression analyses. Results: Three factors were revealed for the CDSS and HAMD-17 factor component analysis. A very similar item loading was found for the CDSS at admission and discharge, whereas results of the loadings of the HAMD-17 items were less stable. The first two factors of the CDSS revealed correlations with positive, negative and general psychopathology. In contrast, multiple significant correlations were found for the HAMD-17 factors and the PANSS subscores. Multiple regression analyses demonstrated that the HAMD-17 accounted more for the positive and negative symptom domains than the CDSS. Conclusions: The present results suggest that compared to the HAMD-17, the CDSS is a more specific instrument to measure depressive symptoms in schizophrenia and schizophrenia spectrum disorder, especially in acutely ill patients.

The structured assessment of depression in brain–damaged individuals: translation and validation study of the Italian version

The aim of this study was to translate the structured assessment of depression in brain-damaged individuals (SADBD) questionnaire into the Italian language, validate, and test reliability and validity of the Italian version. Consecutive patients with stroke were screened in the Department of Neurology, Avogadro University in Novara and the Department of Neurorehabilitation, Maugeri Foundation, Veruno, Italy. Thirty patients were included in the study. The internal consistency ranged between 0.78 and 0.87. The intra-rater test-retest reliability was 0.93 for BDIderived items and 0.82 for HRSD-derived items; while the inter-rater test-retest reliability was 0.94 for BDI-derived items and 0.93 for HRSD-derived items. Correlation between the SADBD diagnosis made by the physician and the nurse was 0.51; correlation between caregiver and physician diagnosis was 0.60. The Italian version of the SADBD was demonstrated to be acceptable, reliable and a valid measure of depression in patients with stroke.

Measurement of depression in patients with chronic obstructive pulmonary disease (COPD)

Objective: To estimate the validity of the Hamilton Depression Scale (HDS) in a population of patients with chronic obstructive pulmonary disease (COPD). Methods: Forty-nine patients with moderate to severe COPD were examined using the ICD-10 criteria for depression. The mean age of the patients was 71 years and 33 (64%) were women. Forty-six (94%) of the patients were also evaluated using the 17-item HDS including the six-item Hamilton Depression subscale (HDSS). Internal and external validity were measured using factor analysis, Cronbach Coefficient alpha, Loevinger coefficient of homogeneity, correlation analysis and ROC-curves. Results: Twenty-three (47%) of the patients were depressed according to the ICD-10 criteria for depression. The HDSS but not the HDS showed a good internal validity. An acceptable external validity was furthermore shown for the HDSS. Conclusion: The HDSS can be recommended as a suitable depression rating scale for COPD patients.

Validity of the Beck Depression Inventory with Eating Disorder Patients

Due to the potential overlap of symptoms in depression and eating disorders, depression inventories may yield misleading results when used with patients with eating disorders. To investigate whether the factor structure of Beck Depression Inventory (BDI) was consistent with a measure of depression in patients with eating disorders, a principle factor analysis was conducted. The results suggest that a single factor was present, wit hall items being correlated with the factor. Consequently, the BDI appears to be an adequate measure of depression in patients with an eating disorder.

Differentiation Between Somatic and Cognitive/Affective Components in Commonly Used Measurements of Depression in Patients with Chronic Low-Back Pain

Patients with chronic low-back pain are frequently diagnosed as depressed. However, many of the neurovegetative signs of depression may also result from pain. The purpose of the present study was 1) to investigate the relationship between commonly used measurements of depression and pain perception; and 2) to examine the utility of differentiating between somatic signs and cognitive/affective symptoms of depression in patients with chronic low-back pain. The Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression were divided into cognitive/affective and somatic subscales. These measures, as well as the Minnesota Multiphasic Personality Inventory, were administered to 111 patients with chronic low-back pain. Analyses revealed significant correlations between depression scores and self-reported pain intensity. The cognitive/affective subscale of the Beck Depression Inventory resulted in the only nonsignificant correlation with pain intensity. These findings suggest that commonly used measurements of depression are confounded with pain symptomatology and that the cognitive/affective category of the Beck Depression Inventory may prove to be a more accurate measurement of depression in patients with chronic low-back pain.

Measurement of depression in patients with cancer.

The recognition or detection of depressive symptoms and syndromes in patients with cancer is of value to the patient because his mental distress may respond to treatment, and to the clinician because some of the clinical complications or difficulties in diagnosis and treatment of the patient may be reduced. Many factors militate against the diagnosis of depressive syndromes in patients with cancer. These include problems with the application of standard sets of criteria for depression, the assumption on the part of medical staff, family, and patients that depression is a "natural" response and therefore not treatable, and the pressure on all involved to "think positive." Some ways of modifying the usual screening and diagnostic procedures for depressive disorders are suggested.